PARLIAMENT HOUSE, Canberra: I also support the motion that Health Insurance (Dental services) Amendment Determination 2012 (No. 1), dated 3 September 2012, made under subsection 3C(1) of the Health Insurance Act 1973, be disallowed. If this disallowance motion does not pass today and if the government’s Dental Benefits Amendment Bill does pass today, three things are going to happen.
The first is that the Medicare Chronic Disease Dental Scheme will end on 30 November, and no new patients will be able to access. Second, it will ensure that people have no coverage at all until at least 14 July. And third it holds up hope that a replacement scheme might be put in place in 2014.
The first two things that I mentioned are certainties—they are facts. If this disallowance motion is not passed and if the government’s package is passed, then those first two things will definitely occur. The Chronic Disease Dental Scheme will be scrapped and there will be nothing in its place until at least 2014. The third thing is just a hope, just an election promise, because there is no detail, it would be implemented after the next election and, most importantly and quite astoundingly, no money has been allocated to it.
So, together, the package the government has put forward is not a good one and we cannot support it. Worse, thousands of people will be left in the lurch over the next 19 months. For this reason we ask that the House support our disallowance motion today, which will at least have the effect of not cancelling the Chronic Disease Dental Scheme, and we ask members to seriously consider how they vote on the government’s package which will be put forward after we have voted on this disallowance motion.
What is the Medicare Chronic Disease Dental Scheme? This scheme was implemented in 2007 when Tony Abbott was health minister. It provides up to $4,250 in Medicare benefits over two years for eligible patients with chronic health conditions.
The intent of the scheme—and the intent has been delivered—was really to recognise that under the universal Medicare scheme we have public assistance for people to get their body fixed but Medicare never covered the teeth and the mouth. There is an inconsistency there because there is no great difference between a chronic health problem in one’s mouth verses a health problem elsewhere. So Tony Abbott, as health minister, introduced this scheme to address that inconsistency. What it meant in practice was that, if you had a chronic teeth problem, you could go to your GP and, if the GP established that indeed you fitted the criteria, that you did have a chronic condition, you could immediately go to one of the 10,000 dentists in Australia and get your condition fixed.
Over the course of the scheme, this cost on average $2,220 per patient, and for kids it cost on average $1,125. The Chronic Disease Dental Scheme slowly worked its way through Australia’s sickest patients and treated an enormous number of them, fixing their teeth. So people who had never had good teeth, people who had chronic conditions but could not afford to see a dentist, all of a sudden had their teeth fixed and for the first time in their life had teeth they could be proud of. One million Australians benefitted from this scheme over the last few years, with 20 million consultations in total.
Why, given the success of this scheme, does the government want to close it down? The government has put forward three reasons to close down the scheme. Firstly, it says the costs are overblown. Indeed, it is the case that the scheme is more expensive than initially forecast, but the reason is that more patients access the scheme. It is a demand-driven program. So the more patients who are eligible to access the scheme, the more expensive it becomes. In this way, it is very different from most of the programs which the current government has introduced and managed which have been budget blowouts because the government have not managed the programs properly. The Medicare Chronic Disease Dental Scheme is not at all like that. We have seen the cost per patient drop over time from an average of $2,225 per patient to this year being an average of $1,117 per patient—per patient, it is becoming less costly. As I said, I distinguish this dental program—a demand-driven program where the cost per patient is becoming less over time but the overall cost to the taxpayer is growing purely because more patients are accessing it—from many of the government’s programs, which have had true cost blowouts purely because of administrative incompetence.
You do not have to think for very long to recognise those programs. The pink batts program is the classic one. It cost $1 billion to put pink batts into people’s roofs and then a further billion dollars to removed the pink batts from people’s roofs. The NBN is another. Initially the NBN was going to cost $4.5 billion and now we are looking at $50 billion and growing, yet still only 50,000 residences have been covered. With school halls, we know from audited accounts that school halls were built for almost twice as much as they should have cost. That is a legitimate cost blowout. With the Chronic Disease Dental Scheme, the additional expenses are due to more patients receiving coverage.
The second reason the government argue the program should be closed down is that they said the program is “untargeted” — that is, that wealthy people are accessing the program. Let us look at the figures. The figures show that 80 per cent of the one million people who accessed this program were concession card holders. More importantly, as the Member for Mackellar pointed out, the fact that our dental scheme is not a means tested program is perfectly consistent with the universally accessed Medicare scheme. Every person in Australia is able to go to a doctor and be covered by Medicare. Every person in Australia is able to go to a public hospital and get free treatment through the Medicare scheme.
Medicare is a universal scheme and until at least this point Medicare has been supported on both sides of the House. As the member for Mackellar pointed out, what is the implication of the government’s argument if, all of a sudden, they say that, if you are a wealthy person, you should not be able to access health care for your mouth through a dental scheme? Is the government also indicating today that they plan to means test the Medicare scheme, because that would be the logical conclusion? I think the Minister for Health should clarify this point because most Australians would be shocked if, indeed, the government were to make the Medicare system no longer a universal scheme. It seems that could be one of their plans and the Minister for Health should clarify that point.
The third argument for why the government plans to close the Chronic Disease Dental Scheme is that they say it has been rorted. About one in 1,500 cases have had some irregularities. In any large-scale government scheme you will never be able to ensure that there are no irregularities.
That is just the nature of things. Some people are going to be completely and utterly dishonest, and no amount of red tape, accounting or oversight is going to ensure that every single irregularity can be removed from the system. One in 1,500 is a similar figure to what we understand occurs through GPs and in the public health system. But the government has not been in here complaining about the Medicare system and saying we should be shutting down Medicare because there is an irregularity in one in 1,500 cases. So the three arguments they have put do not stack up.
The real reason they are planning to close this program down—and it will be closed down if this disallowance motion does not get up—is that Tony Abbott started it. Because Tony Abbott started it when he was health minister, the government does not want to continue it. And the second reason is that the government is desperate to find savings in the budget. They are willing to cut people’s access to dental care in order to find savings because they have wasted so much money elsewhere.
The second certainty which arises from the government’s package, and which will occur if this disallowance motion goes down, is that no scheme will replace it until July 2014 at the very earliest. What this means for the 650,000 people on the dental waiting lists is that the waiting lists will simply get longer. I would like to read out comments from Anya Filek, from Wantirna South in my electorate, a recipient of services under the Chronic Disease Dental Scheme. She says:
I suffer dental problems related to my chronic illness and must visit my dentist every 4 months and now that the dental scheme is gone I will no longer be able to afford it. I have rung my local public health centre and have been placed on a minimum 2 year waiting list but what do I do in 4 months time when my teeth begin to break and crumble as they will do?
How does the Minister propose to ‘extend’ the public dental scheme by 2014 as promised? Will she magically triple the amount of dental chairs in all community health centres?
I would like the Minister for Health to come in here and address Anya’s concerns and tell us what she is going to do about patients like Anya—and there are thousands of other patients in a similar condition.
I will summarise where we are at at the moment. We know for certain that, if this disallowance motion is not passed, the Chronic Disease Dental Scheme will disappear. We know for certain that, if this disallowance motion is not passed, nothing will be put in its place until at least July 2014. The third thing is that the government hopes—and it is just a hope—that it will be able to replace this scheme with something in the distant future, in 19 months time. But, as I pointed out earlier, this is a false promise because their proposal for this dental scheme’s replacement, remarkably, does not begin until 2014—after the next election—and there is no money attached to the bill. So we should consider this as merely an election promise. That is all it is, and we would like to know where the money is coming from.
I plead with the Independents—Mr Oakeshott, Mr Windsor and Mr Katter—and the Greens to support this disallowance motion and keep the Chronic Disease Dental Scheme in place for another 19 months at the very least so that Anya in my electorate and thousands of others like her across Australia can continue to receive the dental treatment they so desperately need.